Gap between risk factors and prevention strategies? A national survey of
falls prevention among medical and surgical patients in China
Abstract
Abstract Rationale, Aims, and Objectives: To determine the extent to
which nurses reportedly assess evidence-based falls risk factors and
identify targeted prevention implemented for medical and surgical
patients in China. Method: This was a multicenter retrospective
observational study. Respondents were nurses working in medical and
surgical units of Chinese 662 hospitals. Fall-risk factors assessments
and targeted interventions by health professionals were collected online
by the Nursing Management Committee of Chinese Nursing Association in
China, in 2019. Results: A total of 68527 valid questionnaires were
recovered (95.0%). In medical and surgical units, nurses were most
likely to report assessing balance, mobility and strength (81.6%) and
orthostatic hypotension (76.4%) for falls and least likely to
continence (61.3%) and feet and footwear (55.8%). Appropriate footwear
(79.3%) and managing syncope, dizziness and vertigo (73.8%) were the
most frequently falls multiple interventions, while managing postural
hypotension (48.8%) and cognitive imparement (48.4%) were the least.
Nine fall-risk factors with clearly matched multifactorial interventions
were determined in medical and surgical units (68.2%~
97.5%). On comparative analysis, Cognitive therapy,
Toileting-assistance, Indwelling catheter, Monitor postural blood
pressure, Dizziness and vertigo interventions, Minimise asthma triggers,
Educating medication use, Keeping floor surface clean and dry were more
common in medical ward, while With the head of the bed raised,
Assessments and referrals and Bed brakes locked in surgical ward.
Conclusion: Health professionals are generally concerned about risk
factors and prevention for falls with their patients in much of China,
however limited attention was directed at the continence, feet and
footwears assessment and managing cognitive imparement. Evidence-based
prevention should be further tailored to the individual, based on an
individual risk factors.